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PUBLISHED IN DUBAI www.dental-tribune.me November-December 2017 | No. 6, Vol. 7 My complete conversion - London lingual orthodontics provider Dr Asif Chatoo describes his navigation of digital technology By Dr Asif Chatoo, London My professional journey has no end or destination. If I ever felt satisfied by one system and I applied it in the same way without acquiring new knowledge or discovering more ad- vanced technologies and materials, I would consider myself ready for re- tirement, which I am certainly not. My voyage through digital technol- ogy, however, has just reached a natural conclusion. I realised recent- ly that I had progressed through all aspects of digital technology as it re- lates to orthodontic treatment and I had completed a circle (Fig. 1). My journey started with photogra- phy some years ago, but the process accelerated, and in recent years, eve- rything has gone digital, including radiography, record-taking, treat- ment planning, and the manufac- ture of brackets and wires. Over the course of my digital con- version, I have tried several dif- ferent systems, all of which have delivered important benefits. The system I have used most as I com- pleted the digital circle over the last two years is suresmile (OraMetrix). It is a treatment management sys- tem and among its benefits is that I am able to provide a highly cus- tomised service in a shorter space of time, saving on average six months of treatment time per patient. I have had a digital scanner for some Fig. 1 time, but this month I acquired an updated 3Shape TRIOS scanner. It is extremely fast and allows my team to take completely accurate and detailed records of patients’ upper and lower arches. In the past, the process took half an hour, but now it is immediate. Adult patients are particularly grateful not to have im- pressions taken, and the orthodon- tic nurses are delighted to avoid this most trying aspect of record-taking. It was invariably messy. Being im- pression-free has brought more val- ue to the team than going paperless. It goes without saying that a key benefit of digital technology is the integration of the orthodontic pro- cesses and records. For instance, a scan of the patient’s teeth can be superimposed on to a photograph, which I can in turn integrate with a grid. I can relate the tooth positions to facial planes and check that the dental midline is centrally located. I can show the patient his or her teeth and bite and I can provide him or her with a visual simulation of the difference that treatment will make. The patient can then ask questions. My vision for the finished result may not be the patient’s vision and being able to manipulate the out- come on screen means one can be absolutely sure the patient under- stands the treatment planning. The patient can influence the treatment if he or she wishes, and if he or she changes his or her mind towards the end, the technology allows for last- minute nuancing. In order to convey how this ap- proach differs from other treat- ments on offer, I compare it to the difference between an off-the-peg suit and going to a tailor in Savile Row. Many of the patients I treat at my practice are referred by leading dentists. Their expectations are high. Some- times orthodontic treatment is just one part of an interdisciplinary treatment that in its entirety will cost in excess of £20,000. Patients expect perfection—in so far as it is possible in an ageing denti- tion—and they expect a high level of service. Suresmile allows me to deliver both. Rightly for a West End practice, many of the benefits of suresmile relate to communication and the care of patients with high expectations, but there are also per- sonal benefits for the clinician. In my case, there is one that sur- passes all others. Bending archwires at the end of treatment is almost always inevitable and it is an aspect I dread. Why am I so hung up on this? The reason is that, if one bends a wire on one tooth, one will affect all the other teeth. This will increase the chairside time. The solution is the robotic wire bending that is cen- tral to suresmile. I aim to deliver several things to my patients: an aesthetic result, a func- tional occlusion and an occlusion that is comfortable at rest. More than anything, I want them to be wowed by their experience. I believe suresmile delivers that wow factor. I have gone 360 degrees and am now fully digital, but this is only the first navigation of new and evolving technology. My orthodon- tic journey continues and I suspect a few more digital revolutions await. Dr Asif Chatoo is a London-based orthodontist and a leading provider of invisible lingual treat- ments. He can be con- tacted at info@londonlingualbraces.com.